For years, scientists have debated whether hormone therapy (HT) is linked to an increased risk of gastroesophageal reflux disease (GERD). A recent comprehensive study and meta-analysis attempt to settle the controversy, revealing a strong correlation between HT use in the past and GERD. The results of the analysis were published online in Menopause, the journal of The North American Menopause Society (NAMS).
GERD is one of the most frequent gastrointestinal disorders. Its worldwide frequency is estimated to be around 14 per cent. Heartburn, dysphagia (difficulty swallowing), and chest discomfort are common symptoms. Risk factors have been identified as anatomical anomalies such as hiatal hernia and obesity. Several medicines, including antidepressants, anti-inflammatory drugs, and HT, have also been related to GERD in several studies, with mixed results, particularly with regard to HT.
Estrogen increases stomach acid production and is associated with higher levels of plasma nitric oxide, which is a key neurotransmitter for the relaxation of the lower esophageal sphincter (LES). Progesterone relaxes the esophageal muscles and the LES, allowing stomach acid to flow back into the esophagus, causing GERD symptoms. Previous research linked female sex hormones with GERD symptoms during pregnancy and with oral contraceptive use. However, the association between HT and GERD in postmenopausal women had remained unclear. A new systematic review and meta-analysis, however, provides clarity by confirming a significant association between ever or current HT use and GERD. Researchers conducted an online search of published randomized, controlled trials and observational studies investigating the association between HT and GERD. Although a total of 84 studies were originally identified, most were eliminated because of irrelevancy or because they were duplicates or associated with conference abstracts. What remained for analysis were five full-length studies that covered more than one million participants. No participants with a prior GERD diagnosis were included.All five studies reported a significant association between estrogen use and GERD, as well as between GERD and HT containing a combination of estrogen plus a progestogen. Women who received combined estrogen-progestogen therapies had a lower risk of GERD symptoms compared with HT containing estrogen alone or progestogen alone.
Source: ANI